A teenage girl walks the hardscrabble streets of Richmond, a Bay Area city, rapping about the challenges of drugs, violence—and diabetes.

Here, she says, big dreams are “coated in sugar,” and innocence is “corrupted with Coke bottles and Ho Ho cupcakes.”

She’s performing in a video by a local youth group that counts diabetes—a national epidemic that has hit California hard—as one of the killers in her neighborhood. The disease, which is spreading and driving up health costs, now impacts more than half of the state’s adults, especially people of color and the poor.

Experts say it doesn’t have to be that way—that prevention programs can slow the march of the illness and save money at the same time. But efforts to legislate prevention—for example, taxing the sugary drinks whose consumption contributes to diabetes—have stalled in the face of heavy opposition by the well-funded beverage lobby.

The state will soon begin funding a program for anti-diabetes education, counseling and lifestyle coaching, but it’s a modest investment regarded only as a start.

“Investing more now in diabetes prevention and education will save our state billions of dollars down the road,” said state Sen. Bill Monning, a Democrat from Carmel who has proposed soda taxes in the past, and tried unsuccessfully this year to require warning labels on sweetened drinks.

A UCLA study last year found that 9 percent of adults in California have been diagnosed with diabetes, a chronic condition in which the body does not process sugar well, which can lead to blindness, heart disease, stroke and infections resulting in amputations. Forty-six percent—including about a third of those under 40—are pre-diabetic, with elevated sugar levels that will likely develop into diabetes.

That’s 55 percent of the state’s adult population swept up by the disease.

Treating diabetes costs government, private insurers and patients about $27.6 billion a year in California, for such expenses as doctor visits, testing, medication, surgery and hospital costs, according to the American Diabetes Association. The state and federal governments shoulder most of that expense through Medi-Cal, California’s health program for those living in poverty, as well as the national Medicare system that covers seniors.

A state audit of the California Department of Public Health diabetes-prevention efforts released two years ago said that California lagged in such spending. The state spent about $1 million from the federal Centers for Disease Control and Prevention, a sum that has since grown to $1.4 million, but did not devote state money to programs. New York, the audit points out, was spending $7.2 million, although some of that money went to anti-obesity programs.

Beginning in July, with the next budget, $5 million in state funds will go toward a nutrition and exercise program for pre-diabetic enrollees in Medi-Cal. That project, based on a CDC model called the Diabetes Prevention Program, can cut the risk of developing diabetes in half, according to the CDC. In addition, it is expected to save about $45 million in treatment expenses over the next five years, said Assemblyman Joaquin Arambula, a Kingsburg Democrat and physician who co-chairs a health subcommittee.

Flojaune Cofer, an epidemiologist and director of state policy and research for the nonprofit Public Health Advocates, said that about 25,000 people will be able to participate each year.

“We can’t just wait until people get sick, because it’s not a viable system,” Cofer said.

The largest state pension fund, CalPERs, began offering the CDC program to through its insurance plans this year, and Medicare will offer it nationally next year. It is also offered by some private insurers.

But adult-onset diabetes, or Type 2, doesn’t get the same attention as some other deadly diseases, such as cancer. Nor is it considered as blameless as Type 1 diabetes, a childhood disease diagnosed when the body produces little or no insulin.

Type 2 is considered mostly preventable by changes in diet and physical activity. But its spread has increased 32 percent in California in the past decade, according to state statistics. The disproportionate impact on low-income communities and people of color may partly explain why it gets short shrift, experts say.

“There’s a general belief that it’s slothful, lazy people making bad choices,” said Dean Schillinger, professor of medicine at the University of California, San Francisco; he’s a leading expert on diabetes and prevention, and was chief of the state’s diabetes-control program from 2008 through 2013. “But if you have to choose between buying a fast-food meal for your family of five for $15 or going to Whole Foods and spending $80 on health food, it’s very rational what people are doing.”

Add to those economics the marketing of beverages and snack foods to children, especially through targeted advertising in low-income communities, and you have a natural intersection for the disease, he said. A federally funded study released this year found that diabetes grew at a rate of 4.8 percent among children each year between 2002 and 2012.

“It’s an unacceptable state of affairs,” Schillinger said. “We can and must do something to prevent young people from having an amputation or being blind by the age of 30.”

Diabetes is also increasing among white people, Schillinger noted, just not as quickly. Sedentary lifestyles, fat-rich diets and time spent in front of screens large and small cut across all communities.

Another contributor is a health care industry that has been primarily focused on treatment instead of prevention, said Monning: “Prevention, including diabetes prevention, is not profit-generating.”

He and a handful of other state legislators have been trying to pass measures to slow the growth of diabetes for years, focusing on the role of sugar-sweetened beverages—because they are the leading cause of increased calories in children. The lawmakers’ targets include not just sodas, but also other sugary drinks camouflaged as more healthful: sports drinks, juices and enriched waters.

Monning tried this year to require labels on certain drinks to state that “drinking beverages with added sugar contributes to obesity, diabetes and tooth decay.” Other efforts have involved a statewide tax on such drinks, but that requires a two-thirds vote of the Legislature and has been a hard sell.

The beverage industry argues that the causes of diabetes are complex, involving much more than soda, and that the best way to build strong, healthy communities is to work together to “help people balance their calories and improve their diets,” said Lauren Kane, a spokeswoman for the American Beverage Association.

The group says taxes don’t work, and labels are misleading.

“America’s beverage companies are already helping people cut their sugar intake from beverages through our collective efforts to reduce portion sizes and introduce smaller, more convenient packages with less sugar,” Kane said.

But Monning blames the industry for pushing hard enough—and spreading enough money around Sacramento—to scare off the “yes” votes needed to pass preventive measures. The beverage group has spent $282,000 on lobbying in California so far this year, according to its required reports to the state. The two largest soda makers, PepsiCo and Coca-Cola, have spent about $248,000. And in the last five years, PepsiCo and Coca-Cola have contributed nearly $783,000 to state candidate campaigns, while the American Beverage Association gave $135,000, the filings show.

There has been a slight decline nationally in the consumption of soda, studies show, although the void may be at least partly filled with other sweet drinks. Experts credit local measures to tax sweetened beverages and require warning labels on billboards that advertise them, among other moves.

Such taxes have been imposed in Berkeley, San Francisco and Oakland. Other cities, including Richmond, have tried and failed to pass them. San Francisco approved a requirement two years ago that certain beverage ads be labeled, but the beverage industry sued to block the measure in a case that is ongoing.

More local taxes and labeling requirements could prompt state lawmakers into action eventually, as plastic-bag bans throughout the state did, said Monning. Once a tipping-point number of cities outlawed the bags, it became easier for the Legislature to adopt a statewide policy.

Schillinger said he has seen firsthand that prevention efforts can stem, or even reverse, an epidemic tide. When he started his medical career, at the height of the AIDS epidemic, half of his patients were dying from HIV infection, he recalls. Within 15 years, that epidemic was pushed back by a combination of grassroots activity, well-funded public health work and scientific research, he said.

“At that time, one out of 15 to 20 of my patients had diabetes,” he said. “Flash forward, and I have no patients with AIDS who are dying. Our AIDS ward is empty. But instead, we have the diabetes epidemic,” and half his patients have the disease.

Schillinger lauds community awareness efforts, like the videos posted by Youth Speaks as part of its diabetes-prevention program. Even armed with statistics and an M.D. degree, Schillinger said, he has participated in too many disappointing policy discussions with lawmakers about diabetes.

“There has to be a different way to talk about this,” he said, “and it has to come from different people.”

Why is a standup comedian pawing through boxes of old family letters—and being so serious as he does it? Why does his wife say she’s the funny one in the family? And how do two Los Angelenos adjust to living in the desert full time?

Meet Tom and Casi Parks.

Tom Parks, 67, was born in Washington, D.C. The eldest of three kids, he went to grade school in South Carolina and high school in New York before spending time in Texas, and ending up in Los Angeles. He studied journalism at the University of Florida—and before long was hosting Not Necessarily the News on HBO.

“To my mom,” he laughs, “doing comedy about the news was doing the news, so I hadn’t totally wasted my education.”

How did Tom end up with a career in comedy? “My mom loved broad slapstick. She roared when my brother hit me in the head with a ball,” he says.

“My dad had a quiet, reserved sense of humor. Dad had served as a bomber pilot in World War II, flying out of England, but was shot down in 1943, a month short of turning 22. He was in a (prisoner of war) camp for 18 months. When I was 14, Hogan’sHeroes ran on TV, and I was worried for my dad. But he started laughing, with tears in his eyes, and said, ‘I don’t remember it being this funny.’

“My mom also served, and she got one more battle decoration than my dad. They always argued about who was the toughest.

”When I graduated college, I was in Atlanta, and I had no idea what I was going to do. I was managing an apartment community, and I met a girl on the stairs. I asked her out (and was) totally shocked when she said yes. We went to see Harry Chapin at the Great Southeast Music Hall. Between his songs, he would tell stories and talk to the audience. I realized that was what I did at parties with friends, and I made them laugh. Friends encouraged me, and two weeks later, I got up onstage in that same club to impress that girl—but I wouldn’t have done it as a career if I hadn’t gotten laughs that night, from strangers. It was a revelation to me, and I’ve never thought of doing anything else.”

Tom’s career started with small college appearances that he booked himself. “(Colleges would) book anything for $100, and to me, that was huge money,” he said. “Once I did a few colleges, I had credits to my name. From 1976 to 1983, I had 700 college dates and was named Campus Entertainer of the Year and Top Comedian.”

Tom’s career includes a first appearance on The Tonight Show in 1987, hosting Not Necessarily the News on HBO in 1989, movies, television, Comic Relief, cruise-ship appearances, a game-show hosting gig, and writing.

In the mid-’80s, Tom was diagnosed with Type 1 diabetes. “I knew it was a possibility, since my dad had it as well, but when I passed age 35, I thought I had missed it.” Tom acted in a humorous film about diabetes which raised about $500,000 for the American Diabetes Association.

Tom’s current passion is old family letters, going back to the 1800s, including correspondence between his dad and grandmother while his dad was at war. Tom writes a blog at www.aboxofoldletters.com to share what he’s found.

Casi Finefrock Parks, 55, was born in Oklahoma City. She has a brother and is the youngest of three sisters. Casi comes from an artistic family: Her parents started a theater, and her two sisters are both painters. She was a dance major at the University of Oklahoma.

“I didn’t finish,” she says. “I got married, and when that was over, I came to Los Angeles, since my brother was in L.A. studying acting. My reaction was, ‘It’s California!’ and I never left.”

Casi went back to school for an accounting degree at California State University, Los Angeles. “I once worked for two gals who were with Prince and the Revolution, running errands for them while I finished school. I never met Prince, but,” she laughs, “I learned that having a backstage pass just means you don’t get to see the show.

“I started doing securities accounting during the online boom. I almost went to work with the FBI, but they said I had to carry a gun—an accountant in bank vaults! I’m very opposed to guns, so I backed out.

“I’ve finally decided to retire because I’m ready for a change, especially following Tom’s heart attack last year, although I may still look for consulting projects.

“I’ve always loved it here in the desert. I’m a big architectural buff, so I do the modernism tours, and there’s so much to explore. Plus, I can run to the store without it taking forever.”

Tom and Casi met online.

“I had never done it before,” she says about online dating. “I was career-oriented and almost 40, so I decided to do a two-week free trial. When I met Tom, I knew immediately.”

They lived together for eight years and married in 2009. “He got on his knee on New Year’s Eve and gave me a box of engraved stationery with both our initials on it. Besides,” she laughs, “I think he was tired of trying to find the right word for me. ‘Girlfriend’ didn’t feel right, and ‘partner’ could have meant a business associate.”

Despite Tom’s career, Casi says she’s the funny one in the family. “Tom is hilarious on stage, but quiet and reserved in real life, while I laugh too much! I talk to everyone, where he hangs back. But he’s the one who is organized at home, even though I’m the accountant.”

What are the challenges of retirement and moving to the desert full-time?

“You don’t end up doing the things you thought you’d do,” says Casi. “We’re remodeling the house, so we have to move out while the work is being done, and we have to build a social life and new friends to hang out with.”

As for Tom: “It didn’t feel like a big move, but it is a big difference,” he says. “I loved L.A., but I’m ready for life to be calmer and quieter.”

Adds Casi: “Life’s easier here, but you do have to keep an eye out for eating too much!”

Anita Rufus is also known as “The Lovable Liberal,” and her radio show airs Sundays at noon on KNews Radio 94.3 FM. Email her at This email address is being protected from spambots. You need JavaScript enabled to view it.. Know Your Neighbors appears every other Wednesday.

Most researchers studying grizzly bears are from the U.S. Fish and Wildlife Service or university ecology departments, not biotechnology companies.

Still, Kevin Corbit, a senior scientist at the Southern California-based biotech firm Amgen, spends his days in a lab in Pullman, Wash., analyzing bear blood. He leaves the actual touching of the 700-pound predator to the capable handlers and their trusty anesthesia. Corbit chuckles as he reflects on his work: “I guess it’s not logical to study bears with a biotech job.”

Maybe it is logical, though, judging from a study he recently published, in collaboration with Washington State University’s Bear Center. With the goal of developing a better long-term treatment for human obesity, Corbit strayed from the status quo of testing mice and rats, which aren’t great predictors of human response. Instead of trying medications on rodents, he decided to examine the genetics of grizzlies and their metabolism. The bears were the perfect fit: Before hibernating each year, they become extraordinarily obese.

In the new study, Corbit and his colleagues discovered a natural state of diabetes in bears that not only serves a real biological purpose, but also is reversible. The bears’ bodies effectively turn up or down their responsiveness to the hormone insulin—much, Corbit says, “like a dimmer switch.” The bears are at their fattest in the late summer, sometimes consuming more than 50,000 calories and gaining up to 16 pounds in a day. But despite the weight gain, they’re at their least diabetic. Their insulin dial is turned up, which helps them store fat for seven months of hibernation.

When the bear hibernates and needs to live off its fat stores, it turns its insulin responsiveness way down. The animal becomes, in human terms, like a Type 2 diabetic, and insulin-resistant. Yet the bear is actually losing, rather than gaining, weight. Year in, year out, despite the extremes of fall gorging, then foodlessness for the entire winter, the bear’s blood sugar remains consistent. It stays healthy thanks to PTEN, a unique genetic mutation (that appears in only some humans) that allows for the insulin dimmer switch.

In addition to pointing out that diabetes is a natural and temporary condition for grizzlies, the research shows that the dominant theory that human obesity and diabetes go hand-in-hand may need rethinking.

Corbit is already thinking about what this could mean for how people are currently treated for the condition. “I worry that giving people insulin over the long-term may end up hurting them,” he says. While injecting insulin in the bloodstream can bring down high blood sugar, it also prevents the breakdown of fat, which leads to cardiovascular problems and other serious medical issues. An alternative treatment for obesity, Corbit thinks, could lie in discovering how exactly grizzlies use the PTEN gene to control their insulin levels.

Ultimately, Corbit wrote in a New York Times op-ed last winter, drug development could take a hint from “millions of years of evolutionary experimentation.” Through unique genetic mutations, animals have evolved in ways to overcome conditions that continue to afflict humans. The new grizzlies research is just one example of how we can learn from them.

“Nature has figured it out,” he says.

Now he just needs to find a way to translate thousands of years of evolution into a treatment for obesity. Slumbering grizzlies may have brought Corbit closer than ever.